Technology Improving Success of Medication-Assisted Treatment in Primary Care

Project Abstract The opioid epidemic is the U.S.andapos;s most widespread behavioral public health problem, with a higher number of deaths due to drug overdose in 2016 compared to deaths due to HIV at the peak of the AIDS epidemic. Medication assisted treatment (MAT) for opioid use disorder (OUD) is highly efficacious. However, only a fraction of persons with OUD access MAT, and treatment non-adherence and drop out is common. There is a dire need to improve systems to address these issues and to expand the use of MAT for many patients who are out of care. This R44 STTR application responds to RFA-DA-19-020, “HEAL Initiative: Americaandapos;s Startups and Small Businesses Build Technologies to Stop the Opioid Crisis.” It joins an outstanding scientific team at UCLA and a small business that has developed, Opioid Addiction Recovery Support (OARS) -- a software platform that by integrating with the Electronic Health Record (EHR) improves clinical management of patients by primary care providers (PCPs) treating patients with OUD using MAT. OARS platform uses a dashboard to show real-time measurement of patient achievements in recovery. It provides opportunities for patients to interact with their PCPs, allowing for better connection to and support from their PCPs. OARS platform features artificial intelligence to analyze information from the EHR and from patients to provide relapse risk assessment for patients receiving MAT for OUD, an innovation that sets OARS apart from other software solutions. The specific aim of Phase 1 of this STTR Fast Track proposal, is to modify the OARS platform for use in primary care settings by conducting interviews with PCPs (N=20) and their patients with OUD (N=40) in primary care settings to collect data on feasibility and acceptability of engaging with OARS to inform user- centered design of OARS. The specific aims of Phase 2 of this STTR Fast Track proposal are to: (1) employ a “stepped wedge” design to assess the effectiveness of OARS in improving opioid agonist treatment outcomes across 6 treatment programs (N=200 treated patients) and (2) evaluate sustainability and return on investment of OARS implementation across 6 treatment programs. A commercialization plan documents progress to date for OARS platform and presents a market plan to improve both scale-up and quality of MAT services delivered by PCPs in primary care, which is a major contribution to addressing the ongoing opioid epidemic.Project Narrative With over 72,000 overdose deaths in 2017, of which 47,600 are attributable to opioid overdose, the opioid epidemic has become North America’s most widespread behavioral public health problem. Medication assisted treatment (MAT) for opioid use disorder (OUD) is highly efficacious. The Opioid Addiction Recovery Support (OARS), comprises of a healthcare team portal connected to a patient mobile application, to provide opioid related education, promote connectedness with clinicians, and track MAT treatment progress. This STTR Fast Track proposal will conduct interviews with patients that will inform optimal design of OARS and utilize a “stepped wedge” effectiveness design to assess the effectiveness of OARS in improving opioid agonist treatment outcomes in primary care settings and evaluate sustainability and return on investment.